Anemia Risk Factor Model in Pregnant Women

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Anemia Risk Factor Model in Pregnant Women

Arinze I. Aninworie, MD, MSc


ABSTRACT:

Background and aim: Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related deaths worldwide. It is curable in the early stages but has a poor prognosis when advanced. Current diagnostic protocols for the early stages of HCC are inefficient. Serum Glypican-3 (GPC-3) is a promising serum tumour marker in diagnosing HCC, and its diagnostic value has been explored in various studies. The outcomes, however, continue to be inconsistent and controversial. This systematic review and meta-analysis aimed to investigate the diagnostic accuracy of serum GPC-3 in hepatocellular carcinoma. This study included recent papers not captured in previous meta-analyses.

Method: PUBMED, MEDLINE, Cochrane Library, and CINAHL databases were systematically searched according to preferred reporting items for a systematic review and meta-analysis of diagnostic test accuracy studies guidelines. Studies on the diagnostic accuracy of serum GPC-3 in HCC were selected. The Quality assessment of diagnostic accuracy studies 2 (QUADAS-2) tools were used to assess the quality of selected studies. Sensitivity, specificity, and other diagnostic parameters were pooled using the random effect model. The Summary receiver operating characteristic (sROC) was used to summarise the diagnostic accuracy of Serum GPC-3.

Results: Eleven studies were included in this systematic review. The pooled sensitivity, specificity, and 95% confidence intervals (CIs) were 0.60 (0.57-0.62) and 0.67(0.64-0.70), respectively. The pooled positive and negative likelihood ratios and 95% CIs were 2.11 (1.51-2.93) and 0.59 (0.51-0.68), respectively; the pooled diagnostic odds ratio and the 95% CI were 4.07 (2.37-6.98), the area under the sROC curve was 0.7194.

Conclusion: This meta-analysis has shown that Serum GPC-3 has an acceptable diagnostic value in diagnosing HCC compared to benign chronic liver diseases. A higher-quality study with a larger sample size is necessary to thoroughly assess the diagnostic utility of serum GPC-3.

 

KEYWORDS:

Glypican 3, Chronic liver diseases, Diagnostic accuracy, HCC, Biomarker.

 

REFERENCES :

1) Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F: Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians 2021, 71(3):209-249.
2) Llovet JM, Kelley RK, Villanueva A, Singal AG, Pikarsky E, Roayaie S, Lencioni R, Koike K, Zucman-Rossi J, Finn RS: Hepatocellular carcinoma. Nat Rev Dis Primers 2021, 7(1):6.
3) Villanueva A: Hepatocellular Carcinoma. N Engl J Med 2019, 380(15):1450-1462.
4) Tejeda-Maldonado J, García-Juárez I, Aguirre-Valadez J, González-Aguirre A, Vilatobá-Chapa M, Armengol-Alonso A, Escobar-Penagos F, Torre A, Sánchez-Ávila JF, Carrillo-Pérez DL: Diagnosis and treatment of hepatocellular carcinoma: An update. World J Hepatol 2015, 7(3):362-376.
5) Aubé C, Oberti F, Lonjon J, Pageaux G, Seror O, N’Kontchou G, Rode A, Radenne S, Cassinotto C, Vergniol J et al: EASL and AASLD recommendations for the diagnosis of HCC to the test of daily practice. Liver Int 2017, 37(10):1515-1525.
6) Hennedige T, Venkatesh SK: Imaging of hepatocellular carcinoma: diagnosis, staging and treatment monitoring. Cancer Imaging 2013, 12(3):530-547.
7) Li J, Wang T, Jin B, Li W, Wang Z, Zhang H, Song Y, Li N: Diagnosis accuracy of serum glypican-3 level in patients with hepatocellular carcinoma: a systematic review with meta-analysis. Int J Biol Markers 2018, 33(4):353-363.
8) Luo P, Wu S, Yu Y, Ming X, Li S, Zuo X, Tu J: Current Status and Perspective Biomarkers in AFP Negative HCC: Towards Screening for and Diagnosing Hepatocellular Carcinoma at an Earlier Stage. Pathol Oncol Res 2020, 26(2):599-603.
9) Choi JY, Lee JM, Sirlin CB: CT and MR imaging diagnosis and staging of hepatocellular carcinoma: part I. Development, growth, and spread: key pathologic and imaging aspects. Radiology 2014, 272(3):635-654.
10) Rastogi A: Changing role of histopathology in the diagnosis and management of hepatocellular carcinoma. World J Gastroenterol 2018, 24(35):4000-4013.
11) Galle PR, Foerster F, Kudo M, Chan SL, Llovet JM, Qin S, Schelman WR, Chintharlapalli S, Abada PB, Sherman M et al: Biology and significance of alpha-fetoprotein in hepatocellular carcinoma. Liver Int 2019, 39(12):2214-2229.
12) Wang W, Wei C: Advances in the early diagnosis of hepatocellular carcinoma. Genes & diseases 2020, 7(3):308-319.
13) Zhou F, Shang W, Yu X, Tian J: Glypican-3: A promising biomarker for hepatocellular carcinoma diagnosis and treatment. Med Res Rev 2018, 38(2):741-767.
14) Nishida T, Kataoka H: Glypican 3-targeted therapy in hepatocellular carcinoma. Cancers 2019, 11(9):1339.
15) Sawada Y, Yoshikawa T, Nobuoka D, Shirakawa H, Kuronuma T, Motomura Y, Mizuno S, Ishii H, Nakachi K, Konishi M et al: Phase I trial of a glypican-3-derived peptide vaccine for advanced hepatocellular carcinoma: immunologic evidence and potential for improving overall survival. Clin Cancer Res 2012, 18(13):3686-3696.
16) Sawada Y, Yoshikawa T, Ofuji K, Yoshimura M, Tsuchiya N, Takahashi M, Nobuoka D, Gotohda N, Takahashi S, Kato Y et al: Phase II study of the GPC3-derived peptide vaccine as an adjuvant therapy for hepatocellular carcinoma patients. Oncoimmunology 2016, 5(5):e1129483.
17) Taniguchi M, Mizuno S, Yoshikawa T, Fujinami N, Sugimoto M, Kobayashi S, Takahashi S, Konishi M, Gotohda N, Nakatsura T: Peptide vaccine as an adjuvant therapy for glypican-3-positive hepatocellular carcinoma induces peptide-specific CTLs and improves long prognosis. Cancer Sci 2020, 111(8):2747-2759.
18) Wu Q, Pi L, Le Trinh T, Zuo C, Xia M, Jiao Y, Hou Z, Jo S, Puszyk W, Pham K et al: A Novel Vaccine Targeting Glypican-3 as a Treatment for Hepatocellular Carcinoma. Mol Ther 2017, 25(10):2299-2308.
19) Guo M, Zhang H, Zheng J, Liu Y: Glypican-3: A New Target for Diagnosis and Treatment of Hepatocellular Carcinoma. J Cancer 2020, 11(8):2008-2021.
20) Wang XY, Degos F, Dubois S, Tessiore S, Allegretta M, Guttmann RD, Jothy S, Belghiti J, Bedossa P, Paradis V: Glypican-3 expression in hepatocellular tumors: diagnostic value for preneoplastic lesions and hepatocellular carcinomas. Hum Pathol 2006, 37(11):1435-1441.
21) Yao M, Yao DF, Bian YZ, Wu W, Yan XD, Yu DD, Qiu LW, Yang JL, Zhang HJ, Sai WL et al: Values of circulating GPC-3 mRNA and alpha-fetoprotein in detecting patients with hepatocellular carcinoma. Hepatobiliary Pancreat Dis Int 2013, 12(2):171-179.
22) Li B, Liu H, Shang HW, Li P, Li N, Ding HG: Diagnostic value of glypican-3 in alpha fetoprotein negative hepatocellular carcinoma patients. Afr Health Sci 2013, 13(3):703-709.
23) Qiao SS, Cui ZQ, Gong L, Han H, Chen PC, Guo LM, Yu X, Wei YH, Ha SA, Kim JW et al: Simultaneous measurements of serum AFP, GPC-3 and HCCR for diagnosing hepatocellular carcinoma. Hepatogastroenterology 2011, 58(110-111):1718-1724.
24) Malov SI, Malov IV, Kuvshinov AG, Marche PN, Decaens T, Macek-Jilkova Z, Yushchuk ND: Search for Effective Serum Tumor Markers for Early Diagnosis of Hepatocellular Carcinoma Associated with Hepatitis C. Sovrem Tekhnologii Med 2021, 13(1):27-33.
25) Caviglia GP, Armandi A, Rosso C, Gaia S, Aneli S, Rolle E, Abate ML, Olivero A, Nicolosi A, Guariglia M et al: Biomarkers of Oncogenesis, Adipose Tissue Dysfunction and Systemic Inflammation for the Detection of Hepatocellular Carcinoma in Patients with Nonalcoholic Fatty Liver Disease. Cancers (Basel) 2021, 13(10).
26) Gomaa SH, Abaza MM, Elattar HA, Amin GA, Elshahawy DM: Soluble cluster of differentiation 26/soluble dipeptidyl peptidase-4 and glypican-3 are promising serum biomarkers for the early detection of Hepatitis C virus related hepatocellular carcinoma in Egyptians. Arab J Gastroenterol 2020, 21(4):224-232.
27) Caviglia GP, Ciruolo M, Abate ML, Carucci P, Rolle E, Rosso C, Olivero A, Troshina G, Risso A, Nicolosi A et al: Alpha-Fetoprotein, Protein Induced by Vitamin K Absence or Antagonist II and Glypican-3 for the Detection and Ozkan H, Erdal H, Koçak E, Tutkak H, Karaeren Z, Yakut M, Köklü S: Diagnostic and prognostic role of serum glypican 3 in patients with hepatocellular carcinoma. J Clin Lab Anal 2011, 25(5):350-353.
28) Xu D, Su C, Sun L, Gao Y, Li Y: Performance of Serum Glypican 3 in Diagnosis of Hepatocellular Carcinoma: A meta-analysis. Ann Hepatol 2019, 18(1):58-67.
29) Liu J, Zuo X, Wang S: Diagnosis accuracy of serum Glypican-3 level in patients with hepatocellular carcinoma and liver cirrhosis: a meta-analysis. Eur Rev Med Pharmacol Sci 2015, 19(19):3655-3673.
30) Fu W, Lu H, Li L, Wu K, Li Y, Liu Y, Hu J: Glypican-3 versus alpha-fetoprotein as a biomarker for hepatocellular carcinoma: a diagnostic meta-analysis. Biocell 2015, 39(2-3):25-31.
31) Liu XF, Hu ZD, Liu XC, Cao Y, Ding CM, Hu CJ: Diagnostic accuracy of serum glypican-3 for hepatocellular carcinoma: a systematic review and meta-analysis. Clin Biochem 2014, 47(3):196-200.
32) Jia X, Liu J, Gao Y, Huang Y, Du Z: Diagnosis accuracy of serum glypican-3 in patients with hepatocellular carcinoma: a systematic review with meta-analysis. Arch Med Res 2014, 45(7):580-588.
33) Xu C, Yan Z, Zhou L, Wang Y: A comparison of glypican-3 with alpha-fetoprotein as a serum marker for hepatocellular carcinoma: a meta-analysis. Journal of cancer research and clinical oncology 2013, 139(8):1417-1424.
34) Sharma A, Nagalli S: Chronic liver disease. In: StatPearls [Internet]. edn.: StatPearls Publishing; 2021.
35) Wu M, Liu Z, Li X, Zhang A, Li N: Dynamic Changes in Serum Markers and Their Utility in the Early Diagnosis of All Stages of Hepatitis B-Associated Hepatocellular Carcinoma. OncoTargets and therapy 2020, 13:827-840.
36) McInnes MDF, Moher D, Thombs BD, McGrath TA, Bossuyt PM, Clifford T, Cohen JF, Deeks JJ, Gatsonis C, Hooft L et al: Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies: The PRISMA-DTA Statement. Jama 2018, 319(4):388-396.
37) Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, Leeflang MM, Sterne JA, Bossuyt PM, Group* Q-: QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Annals of internal medicine 2011, 155(8):529-536.
38) Jon Deeks PB, Mariska Leeflang,, Yemisi Takwoingi, Flemyng. E: Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy version 2.0. In. Edited by Editor) JDSS, Editor) PBSS, Editor) MLAS, Editor) YTAS, Editor) EFM, 2.0 edn; 2022.
39) Zamora J, Abraira V, Muriel A, Khan K, Coomarasamy A: Meta-DiSc: a software for meta-analysis of test accuracy data. BMC Med Res Methodol 2006, 6:31.
40) CochraneCollaboration: Review Manager (RevMan) [Computer program]. Version 5.4. The Cochrane Collaboration, 2020. In., 5.4.1 edn; 2020.
41) Wang J, Leeflang M: Recommended software/packages for meta-analysis of diagnostic accuracy. Journal of Laboratory and Precision Medicine 2019, 4.
42) AS R, Korsten M: Application of summary receiver operating characteristics (sROC) analysis to diagnostic clinical testing. 7 Reflections on the future of gastroenterology–unmet needs 2007, 52:76.
43) Walter S: Properties of the summary receiver operating characteristic (SROC) curve for diagnostic test data. Statistics in medicine 2002, 21(9):1237-1256.
44) Shreffler J, Huecker MR: Diagnostic Testing Accuracy: Sensitivity, Specificity, Predictive Values and Likelihood Ratios. In: StatPearls. edn. Treasure Island (FL): StatPearls Publishing
Copyright © 2022, StatPearls Publishing LLC.; 2022.
45) Glas AS, Lijmer JG, Prins MH, Bonsel GJ, Bossuyt PM: The diagnostic odds ratio: a single indicator of test performance. J Clin Epidemiol 2003, 56(11):1129-1135.
46) Šimundić AM: Measures of Diagnostic Accuracy: Basic Definitions. Ejifcc 2009, 19(4):203-211.
47) Walter SD: Properties of the summary receiver operating characteristic (SROC) curve for diagnostic test data. Stat Med 2002, 21(9):1237-1256.
48) Macaskill P, Gatsonis C, Deeks J, Harbord R, Takwoingi Y: Cochrane handbook for systematic reviews of diagnostic test accuracy. In.: Version; 2010.
49) Devillé WL, Buntinx F, Bouter LM, Montori VM, de Vet HC, van der Windt DA, Bezemer PD: Conducting systematic reviews of diagnostic studies: didactic guidelines. BMC Med Res Methodol 2002, 2:9.
50) Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D: The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Journal of clinical epidemiology 2009, 62(10):e1-e34.
51) Jeon Y, Jang ES, Choi YS, Kim J-W, Jeong S-H: Glypican-3 level assessed by the enzyme-linked immunosorbent assay is inferior to alpha-fetoprotein level for hepatocellular carcinoma diagnosis. Clinical and molecular hepatology 2016, 22(3):359-365.
52) ttallah AM, El-Far M, Omran MM, Abdelrazek MA, Attallah AA, Saeed AM, Farid K: GPC-HCC model: a combination of glybican-3 with other routine parameters improves the diagnostic efficacy in hepatocellular carcinoma. Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine 2016, 37(9):12571-12577.
53) Lee HJ, Yeon JE, Suh SJ, Lee SJ, Yoon EL, Kang K, Yoo YJ, Kim JH, Seo YS, Yim HJ et al: Clinical utility of plasma glypican-3 and osteopontin as biomarkers of hepatocellular carcinoma. Gut and liver 2014, 8(2):177-185.
54) Tangkijvanich P, Chanmee T, Komtong S, Mahachai V, Wisedopas N, Pothacharoen P, Kongtawelert P: Diagnostic role of serum glypican-3 in differentiating hepatocellular carcinoma from non-malignant chronic liver disease and other liver cancers. Journal of gastroenterology and hepatology 2010, 25(1):129-137.
55) Liu H, Li P, Zhai Y, Qu C-F, Zhang L-J, Tan Y-F, Li N, Ding H-G: Diagnostic value of glypican-3 in serum and liver for primary hepatocellular carcinoma. World journal of gastroenterology 2010, 16(35):4410-4415.
56) Ranganathan P, Aggarwal R: Common pitfalls in statistical analysis: Understanding the properties of diagnostic tests – Part 1. Perspect Clin Res 2018, 9(1):40-43.
57) Mandrekar JN: Receiver operating characteristic curve in diagnostic test assessment. J Thorac Oncol 2010, 5(9):1315-1316.
58) Moses LE, Shapiro D, Littenberg B: Combining independent studies of a diagnostic test into a summary ROC curve: data-analytic approaches and some additional considerations. Stat Med 1993, 12(14):1293-1316.
59) Deeks JJ, Macaskill P, Irwig L: The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed. J Clin Epidemiol 2005, 58(9):882-893.
60) Wardle J, Robb K, Vernon S, Waller J: Screening for prevention and early diagnosis of cancer. American psychologist 2015, 70(2):119.
61) Hawkes N: Cancer survival data emphasise importance of early diagnosis. In.: British Medical Journal Publishing Group; 2019.
62) Kim M-J: Current limitations and potential breakthroughs for the early diagnosis of hepatocellular carcinoma. Gut and Liver 2011, 5(1):15.
63) Sherman M: Optimum imaging for small suspected hepatocellular carcinoma. Gut 2010, 59(5):570-571.
64) Tsuchiya N, Sawada Y, Endo I, Saito K, Uemura Y, Nakatsura T: Biomarkers for the early diagnosis of hepatocellular carcinoma. World J Gastroenterol 2015, 21(37):10573-10583.
65) Wang T, Zhang K-H: New blood biomarkers for the diagnosis of AFP-negative hepatocellular carcinoma. Frontiers in Oncology 2020, 10:1316.
66) Crombie IK, Davies HT: What is meta-analysis. What is 2009, 1(8).
67) Kim HS, El-Serag HB: The Epidemiology of Hepatocellular Carcinoma in the USA. Curr Gastroenterol Rep 2019, 21(4):17.
68) Ghouri YA, Mian I, Rowe JH: Review of hepatocellular carcinoma: Epidemiology, etiology, and carcinogenesis. J Carcinog 2017, 16:1.
69) IntHout J, Ioannidis JP, Borm GF, Goeman JJ: Small studies are more heterogeneous than large ones: a meta-meta-analysis. Journal of clinical epidemiology 2015, 68(8):860-869.
70) Kleeberger C, Shore D, Gunter E, Sandler DP, Weinberg CR: The Effects of Long-term Storage on Commonly Measured Serum Analyte Levels. Epidemiology 2018, 29(3):448-452.

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